Previous studies have indicated that stuttering influences the work life of adults who stutter (AWS), and reasonable accommodations for AWS in the workplace are needed. However, few studies have examined specific, reasonable accommodations for AWS. We conducted a questionnaire on the work life and reasonable accommodations of 182 AWS. Results showed that stuttering heavily influenced their work life, with AWS having trouble talking on the telephone, conversing with a large number of people, giving presentations, and participating in morning meetings. Necessary reasonable accommodations included "to be acquainted with stuttering," "to accept AWS," "to comprehend trigger situations and words that may cause stuttering," and "to consider their stuttering when evaluating AWS." Younger AWS had more difficulties in work life, and needed more accommodations, than older AWS. This study addressed the actual work life of AWS and highlighted necessary, reasonable accommodations.

Alaryngeal speech using a voice prosthesis after total laryngectomy has the advantage of enabling patients to acquire speech more rapidly, and thus enables early speech communication. The voices of 14 patients who underwent total laryngectomy between June 2011 and June 2013 were restored using a Provox® 2. Voice quality was assessed using the VHI-10, maximum phonation time, speech articulation, and spectrum analyses. We also compared outcomes between patients who had been treated by cervical esophagus reconstruction with pharyngeal mucosa (T-E) and those treated either with free jejunum or a gastric tube (T-J/T-G). The T-E group had a longer maximum phonation time and better speech articulation (r=-0.73, p<0.05), but these did not significantly correlate in the T-J/T-G group. Spectrum analysis of one representative patient from each of the T-E and T-J groups showed that the T-E patient had more periodic harmonic components, whereas the T-J patient had strong non-harmonic components. In addition, slightly rough periodic components overlapped with non-harmonic components in one T-G patient. All patients acquired the prosthetic voice soon after surgery. However, two patients in the T-E group who experienced difficulties with articulation due to hypertonic phonation required rehabilitation. The quality of an acquired prosthetic voice seems to differ according to the method of reconstruction. Rehabilitation based on the voice generation process might be useful.

We investigated voice disorders in patients who received voice therapy, and no other therapy, at our hospital. Based on our previous experience, we chose an end point for the voice therapy of 6.0 sessions over a span of 3.5 months. For this study, we again divided the patients into two groups: those who completed the therapy and those who dropped out before completion. We investigated the end point of voice therapy for each disorder individually, and compared those individual results against the results, in terms of number of sessions and months of voice therapy, obtained earlier for all cases collectively. We found no significant differences. We therefore concluded that the timing of the end of voice therapy at 6.0 sessions over 3.5 months is valid for all types of voice disorder.

The present study was conducted to investigate the types of emotions that can be expressed by prosody and the age from which a listener can understand the communicative intents of a speaker through the linguistic contents and affective prosody of the spoken phrases. The subjects were 119 typically developing children (TDC) attending kindergarten or lower grades of elementary school. The phrases used in the tasks were short phrases that the children hear in their daily conversations, and voices with different prosodies were used. Four types of spoken phrases with different prosody expressing "acceptance," "bluffing," "rejection" and "fooling" were presented. The results revealed that the rate of understanding, as compared to that in adults, was 100% (equal to that in adults) for "acceptance" in 4- and 5-year-old children in the second year of kindergarten or older children, about 90% for "bluffing" in children in the second year of kindergarten, and about 90% for "rejection" in children in the third year of kindergarten. By contrast, the rate of understanding, as compared to that in adults, of "fooling" was only 8% in 3- and 4-year-old children in the first year of kindergarten, but more than 90% in school-age children. Thus, significant age-dependent differences in the rate of understanding of "fooling," as compared to the other emotions tested, were found between preschool children and elementary school children.From the results of this study, 4 types of communicative intents of voice tasks, particularly the task for communicating "fooling," were identified as useful tasks for objective evaluation of the ability of children to understand the communicative intents of those that speak to them even from very early childhood.

Objective: Botulinum toxin (BT) is one of the important treatments administered to patients with adductor spasmodic dysphonia (ADSD); however, the detailed effects of this treatment over time are not well known. The purpose of this study is to evaluate longitudinal subjective vocal changes after BT injections in patients with ADSD. Methods: Thirteen patients with ADSD were involved in this retrospective observational study (2 men and 11 women, onset age 24.8±7.9 years, range 11-40 years). Subjective vocal symptom scores and complications were recorded after the BT injections. The Ethics Committee of Teikyo University approved this study (approval number 13-256). Results: Improvement of subjective vocal symptoms appeared within 1.8 (±0.8) days. The highest score was obtained at 2.9 (±2.0) weeks after the BT injections and continued until 6.3 (±2.9) weeks. Side effects appeared in 97.4% of the subjects. Scores decreased after 8.6 (±2.8) weeks, and the next BT injections were required at 10.1 (±3.3) weeks. Minor complications appeared within 2.5 (±1.3) days, and very minor complications lasted for 2.8 (±1.5) weeks. The mean interval of the BT injections was 3.1 (±0.7) months. Conclusions: We clarified the longitudinal effects of BT treatment. By providing ADSD patients with accurate and detailed explanation of the treatment in advance, they are shown to suffer less anxiety and are less prone to discontinue the BT therapy.

Reading accuracy and fluency tests were conducted on 38 primary school children, 1st to 6th grade, with developmental dyslexia. Reading duration was measured using stimuli of Hiragana and Katakana words and non-words and paragraphs. Response time was estimated using discrete Kana characters: Hiragana, Katakana and Kanji words. We found 8 children showing fluency problem only, with normal accuracy. In contrast, 3 children manifested accuracy problem only, with normal fluency. In the reading fluency test, 35 children showed 2 SD slower than the mean score of their age-matched normal children. A total of 25 out of 35 children, that is 71%, manifested more than 2 seconds delay in discrete character reading, and also showed delayed duration time in the reading speed test. These results suggest that accuracy and fluency are independent variables. It is possible that delayed response time in discrete character reading can be used to predict reading duration time in more than 70% children.

The Japanese language includes several scripts: Kanji, Hiragana and Katakana. The dual neural circuit model of reading suggests that the logographic Kanji are processed in the posterior inferior temporal area, while the syllabic Kana (Katakana and Hiragana) are processed in the lateral occipital area. However, the differences in processing between Hiragana and Katakana syllabaries remain uncertain. We used functional magnetic resonance imaging to investigate the effect of high versus low orthographic validity, as well as areas of activation associated with reading Hiragana and Katakana aloud, in twenty-nine healthy participants. In the Katakana task, a high orthographic validity task activated the left orbital, fusiform and middle occipital gyri as well as the calcarine sulcus; meanwhile in the low orthographic validity Katakana task, activation was observed in the left middle frontal, fusiform, angular, right superior frontal, and medial superior frontal gyri. In the high orthographic validity task for Hiragana, significant activation was observed in the left and right middle temporal, middle occipital, left orbital, angular, and right anterior cingulate gyri; meanwhile in the low orthographic validity task, the left orbital and fusiform gyri were activated. These results indicate that Hiragana and Katakana are processed by dorsal pathway in the dual neural circuit model of reading, and that orthographic validity influences visual cognition and integration of word-related information.

Werner's syndrome is a hereditary disorder characterized by premature aging. The chief complaints include conditions associated with aging, such as cataracts, atrophic skin, and scleroderma; additionally, voice disorders are also diagnostic for this condition. This report describes a 42-year-old female patient diagnosed with Werner's syndrome by hereditary analysis. The patient complained that the condition of her voice had been progressively deteriorating over a period of 30 years. Endoscopic findings showed stiffness and atrophy of the vocal cords. Her voice was rough and breathy, and the maximum phonation time was 3 seconds. The vocal condition did not improve with medical therapy; however, she did not require surgery as an additional treatment. As the patient gradually developed sclerosis of the skin and finger contracture, she was diagnosed as having Werner's syndrome through a genetic test conducted in our Department of Dermatology. Voice disorders have been observed in 80% of patients with Werner's syndrome. These vocal changes are often attributed to vocal cord atrophy. Due to complications of malignant or metabolic diseases, effective treatment of vocal hoarseness may be difficult. It is important to treat the vocal conditions according to the patient's specific requirements and physical condition.